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Management of Bilateral Glottic Tumors

Management of Bilateral Glottic Tumors Abstract Objective: To compare the rates of cure and complication and the time to decannulation and deglutition in patients undergoing resection of bilateral glottic tumors. Design: A 22-year, nonrandomized, prospective, retrospective analysis. Setting: Two academic tertiary care referral centers. Participants: Seventy-two patients with bilateral glottic carcinoma were treated using bilateral hemilaryngectomy. Depending on the size of the tumor and the extent of thyroid cartilage resection, patients underwent 1 of 3 methods of reconstruction: group 1, placement of an anterior commissure stent (34 patients); group 2, epiglottic laryngoplasty (15 patients); and group 3, staged posterior thyroid alar transposition laryngoplasty (23 patients). Intervention: Resection and reconstruction of 72 larynges with bilateral glottic tumors using the bilateral hemilaryngectomy procedures. Main Outcome Measures: Acceptable rates of cure and complication, intervals to decannulation and deglutition, and quality of speech. Results: High rates of tumor control and cure, low rates of recurrence and complication, acceptable time to decannulation and deglutition, and adequate quality and intelligibility of speech. Conclusions: Bilateral vocal cord carcinoma can be treated surgically with a high degree of tumor control and cure. The use of all 3 methods maintained laryngeal function with regard to tracheal decannulation, oral alimentation, and speech intelligibility.Arch Otolaryngol Head Neck Surg. 1997;123:465-473 References 1. Tucker HM, Wood BG, Levine HL, et al. Glottic reconstruction after near total laryngectomy . Laryngoscope . 1977;89:609-618. 2. Silver CE. Surgery for Cancer of the Larynx and Related Structures . New York, NY: Churchill Livingstone Inc; 1981:225-235. 3. Bailey BJ. Partial laryngectomy and laryngoplasty: a technique and review . Trans Am Acad Ophthalmol Otolaryngol . 1966;70:559-574. 4. Billroth T. Cancer of the Larynx . New York, NY: Macmillan Publishing Co Inc; 1930:136-142. 5. Quinn HJ Jr. A new technique for glottic reconstruction after partial laryngectomy . Laryngoscope . 1969;79:1980-2011.Crossref 6. Gluck T. Die Resektion und extirpation der Larynx, Pharynx und Oesphagus . In: Gluck T, Soerensen J, eds. Handbuck de Chirurgie de Ohres, und der Oberon Luftwege . 350-359. 7. Gluck T, Soerensen J. The surgical treatment of cancer of the larynx . Jahrb Aertzl Forbldg . 1912;11:20-41. 8. Gluck T, Kirschner M, Lautenschlalager A, et al. Operative Surgery . Philadelphia, Pa: JB Lippincott; 1937:110-125. 9. Myerson MC. The Human Larynx . Springfield, Ill: Charles C Thomas Publisher; 1964:327-329. 10. Broyles EN. New operative procedure for laryngofissure . South Med J . 1949; 42:825-827.Crossref 11. Clerf LH. Carcinoma of the larynx: an analysis of 250 operative cases . Arch Otolaryngol . 1940;32:484-496.Crossref 12. Norris CM. Technique of extended frontolateral partial laryngectomy . Laryngoscope . 1958;68:1240-1250.Crossref 13. McGavran MH, Spjut HJ, Ogura JH. Laryngofissure in the treatment of laryngeal carcinoma: a critical analysis of success and failure . Laryngoscope . 1953; 69:44-53. 14. Biller HF, Lawson W. Bilateral vertical partial laryngectomy for bilateral vocal cord carcinoma . Ann Otol Rhinol Laryngol . 1981;90:489-491. 15. American Joint Committee on Cancer. Manual for Staging of Cancer . 4th ed. Philadelphia, Pa: JB Lippincott; 1992. 16. Conley J. Regional skin flaps in partial laryngectomy . Laryngoscope . 1975; 85942-949.Crossref 17. Hoasjoe DK, Martin GF, Doyle PC, et al. A comparative acoustic analysis of voice production by near-total laryngectomy and normal laryngeal speakers . J Otolaryngol . 1992;21:39-43. 18. Fairbanks G. Voice and Articulation Drillbook . 2nd ed. New York, NY: Harper-Collins Publications Inc; 1960:45-60. 19. Goodyear HM. Hemilaryngectomy: method of maintaining a satisfactory airway and voice . Ann Otol Rhinol Laryngol . 1949;58:581-585. 20. Som ML. Hemilaryngectomy: a modified technique for cordal carcinoma with extension posteriorly . Arch Otolaryngol Head Neck Surg . 1951;54:524-533.Crossref 21. Conley J. The use of mucosal flaps for wound rehabilitation in partial laryngectomy . Arch Otolaryngol Head Neck Surg . 1959;69:700-703.Crossref 22. Conley J. Glottic reconstruction and wound rehabilitation: procedures in partial laryngectomy . Arch Otolaryngol Head Neck Surg . 1961;74:239-242.Crossref 23. Pressman J. Cancer of the larynx: laryngoplasty to avoid laryngectomy . Arch Otolaryngol . 1954;59:395-412.Crossref 24. Dedo HH. A technique for vertical hemilaryngectomy to prevent stenosis and aspiration . Laryngoscope . 1975;85:978-984.Crossref 25. Kirchner JA, Som ML. The anterior commissure technique of partial laryngectomy: clinical and laboratory observations . Laryngoscope . 1975;85:1308-1317.Crossref 26. Sedlacek K. Reconstructive anterior and lateral laryngectomy with the use of the epiglottis for the pedicle graft [in Czech] . Cesk Otolaryngol . 1965;8:328-338. 27. Kambic V. Epiglottoplasty: new technique for laryngeal reconstruction . Radiologia lugoslavica . 1977; (suppl II) :33-43. 28. Nong H, Mo W, Huang G, et al. Epiglottic laryngoplasty after hemilaryngectomy . Arch Otolaryngol Head Neck Surg . 1991;104:809-813. 29. Chiari O. Chirurgie des Kehlkopfes und der Luftrohre . In: Neue Deutsche Chirurgie . Stuttgart, Germany: Enke; 1916;8:55-75. 30. Conley J. Rehabilitation of the airway system by neck flaps . Ann Otol Rhinol Laryngol . 1962;71:404-410. 31. Laccourreye O, Menard M, Weinstein G, et al. Supracricoid laryngectomy with cricohyoidepiglottopexy: a partial laryngeal procedure for glottic carcinoma . Ann Otol Rhinol Laryngol . 1990;99:421-426. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1997.01900050011001
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Abstract

Abstract Objective: To compare the rates of cure and complication and the time to decannulation and deglutition in patients undergoing resection of bilateral glottic tumors. Design: A 22-year, nonrandomized, prospective, retrospective analysis. Setting: Two academic tertiary care referral centers. Participants: Seventy-two patients with bilateral glottic carcinoma were treated using bilateral hemilaryngectomy. Depending on the size of the tumor and the extent of thyroid cartilage resection, patients underwent 1 of 3 methods of reconstruction: group 1, placement of an anterior commissure stent (34 patients); group 2, epiglottic laryngoplasty (15 patients); and group 3, staged posterior thyroid alar transposition laryngoplasty (23 patients). Intervention: Resection and reconstruction of 72 larynges with bilateral glottic tumors using the bilateral hemilaryngectomy procedures. Main Outcome Measures: Acceptable rates of cure and complication, intervals to decannulation and deglutition, and quality of speech. Results: High rates of tumor control and cure, low rates of recurrence and complication, acceptable time to decannulation and deglutition, and adequate quality and intelligibility of speech. Conclusions: Bilateral vocal cord carcinoma can be treated surgically with a high degree of tumor control and cure. The use of all 3 methods maintained laryngeal function with regard to tracheal decannulation, oral alimentation, and speech intelligibility.Arch Otolaryngol Head Neck Surg. 1997;123:465-473 References 1. Tucker HM, Wood BG, Levine HL, et al. Glottic reconstruction after near total laryngectomy . Laryngoscope . 1977;89:609-618. 2. Silver CE. Surgery for Cancer of the Larynx and Related Structures . New York, NY: Churchill Livingstone Inc; 1981:225-235. 3. Bailey BJ. Partial laryngectomy and laryngoplasty: a technique and review . Trans Am Acad Ophthalmol Otolaryngol . 1966;70:559-574. 4. Billroth T. Cancer of the Larynx . New York, NY: Macmillan Publishing Co Inc; 1930:136-142. 5. Quinn HJ Jr. A new technique for glottic reconstruction after partial laryngectomy . Laryngoscope . 1969;79:1980-2011.Crossref 6. Gluck T. Die Resektion und extirpation der Larynx, Pharynx und Oesphagus . In: Gluck T, Soerensen J, eds. Handbuck de Chirurgie de Ohres, und der Oberon Luftwege . 350-359. 7. Gluck T, Soerensen J. The surgical treatment of cancer of the larynx . Jahrb Aertzl Forbldg . 1912;11:20-41. 8. Gluck T, Kirschner M, Lautenschlalager A, et al. Operative Surgery . Philadelphia, Pa: JB Lippincott; 1937:110-125. 9. Myerson MC. The Human Larynx . Springfield, Ill: Charles C Thomas Publisher; 1964:327-329. 10. Broyles EN. New operative procedure for laryngofissure . South Med J . 1949; 42:825-827.Crossref 11. Clerf LH. Carcinoma of the larynx: an analysis of 250 operative cases . Arch Otolaryngol . 1940;32:484-496.Crossref 12. Norris CM. Technique of extended frontolateral partial laryngectomy . Laryngoscope . 1958;68:1240-1250.Crossref 13. McGavran MH, Spjut HJ, Ogura JH. Laryngofissure in the treatment of laryngeal carcinoma: a critical analysis of success and failure . Laryngoscope . 1953; 69:44-53. 14. Biller HF, Lawson W. Bilateral vertical partial laryngectomy for bilateral vocal cord carcinoma . Ann Otol Rhinol Laryngol . 1981;90:489-491. 15. American Joint Committee on Cancer. Manual for Staging of Cancer . 4th ed. Philadelphia, Pa: JB Lippincott; 1992. 16. Conley J. Regional skin flaps in partial laryngectomy . Laryngoscope . 1975; 85942-949.Crossref 17. Hoasjoe DK, Martin GF, Doyle PC, et al. A comparative acoustic analysis of voice production by near-total laryngectomy and normal laryngeal speakers . J Otolaryngol . 1992;21:39-43. 18. Fairbanks G. Voice and Articulation Drillbook . 2nd ed. New York, NY: Harper-Collins Publications Inc; 1960:45-60. 19. Goodyear HM. Hemilaryngectomy: method of maintaining a satisfactory airway and voice . Ann Otol Rhinol Laryngol . 1949;58:581-585. 20. Som ML. Hemilaryngectomy: a modified technique for cordal carcinoma with extension posteriorly . Arch Otolaryngol Head Neck Surg . 1951;54:524-533.Crossref 21. Conley J. The use of mucosal flaps for wound rehabilitation in partial laryngectomy . Arch Otolaryngol Head Neck Surg . 1959;69:700-703.Crossref 22. Conley J. Glottic reconstruction and wound rehabilitation: procedures in partial laryngectomy . Arch Otolaryngol Head Neck Surg . 1961;74:239-242.Crossref 23. Pressman J. Cancer of the larynx: laryngoplasty to avoid laryngectomy . Arch Otolaryngol . 1954;59:395-412.Crossref 24. Dedo HH. A technique for vertical hemilaryngectomy to prevent stenosis and aspiration . Laryngoscope . 1975;85:978-984.Crossref 25. Kirchner JA, Som ML. The anterior commissure technique of partial laryngectomy: clinical and laboratory observations . Laryngoscope . 1975;85:1308-1317.Crossref 26. Sedlacek K. Reconstructive anterior and lateral laryngectomy with the use of the epiglottis for the pedicle graft [in Czech] . Cesk Otolaryngol . 1965;8:328-338. 27. Kambic V. Epiglottoplasty: new technique for laryngeal reconstruction . Radiologia lugoslavica . 1977; (suppl II) :33-43. 28. Nong H, Mo W, Huang G, et al. Epiglottic laryngoplasty after hemilaryngectomy . Arch Otolaryngol Head Neck Surg . 1991;104:809-813. 29. Chiari O. Chirurgie des Kehlkopfes und der Luftrohre . In: Neue Deutsche Chirurgie . Stuttgart, Germany: Enke; 1916;8:55-75. 30. Conley J. Rehabilitation of the airway system by neck flaps . Ann Otol Rhinol Laryngol . 1962;71:404-410. 31. Laccourreye O, Menard M, Weinstein G, et al. Supracricoid laryngectomy with cricohyoidepiglottopexy: a partial laryngeal procedure for glottic carcinoma . Ann Otol Rhinol Laryngol . 1990;99:421-426.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: May 1, 1997

References